Fetomaternal outcome in women with grandmultiparity and multiparity

To compare the maternal and neonatal outcome in multiparas and grand multiparas. Study. This prospective study was carried out in outpatient Department of Obstetrics and Gynaecology, Quaid-e-Azam Medical College, Bahawal Victoria Hospital, Bahawalpur from January 2009 to June 2009, A total of 380 deliveries were recorded in this study and divided into equal two groups A and B. The mean ages among the groups were not significantly different. Majority of the patients belong to the age groups of 31-35 years, With regards to gestational age, majority of the patients were found between 37-40 weeks of gestation in both groups [A and B]. We found 70.52% [n=134] with vaginal delivery in Group-B and 44.74% [n=85] in Group-A; abdominal delivery in 29.48% [n=56] in Group-B and 55.26% [n=105] in Group-A. Maternal morbidity regarding Anemia, APH, Stillbirth, PIH, Preterm delivery was analyzed and found a significant higher rate. Neonatal outcome with regards to Apgar score <6 at 1 minute, it was found present in 11.05% [n=21] in Group-A and 4.73% [n=9] in Group-B, while rest of patients i.e. 88.94% [n=169] in Group-A and 95.27% [n=181] in Group-B were found to have neonatal Apgar score of >6 at 1 minute. Grand multiparity is still a major obstetrics hazard in our set up with higher incidence of complications

Complications of grandmultipara as compared with women of low parity

The objectives of the study were to: 1. List the different complications of Grand multipara. 2. Compare the complications of Grand multipara with women of low parity. 3. Compare the fetal outcomes of Grand multipara with women of low parity. Study Design: Cross sectional Setting: Post natal Wards of Gynae unit I, II and III of Abbasi Shaheed Hospital and Sobhraj Maternity Hospital Duration of study: April to Aug 2008 Sample size: 100 Complications in grand multipara had been found in 80% of cases as compared to 20% of women with low parity. Abortion rate was found to be higher in grand multipara [3%] as compared with women of low parity [0%]. Twelve% of newborns were born by breech presentation in grand multipara as compare to just 4% in women of low parity. Regarding the fetal outcome, 5% of grand multipara gave birth to dead newborns as compared to only 1% of women of low parity. Grand multipara had more maternal and fetal complications as compared to women of low parity

Maternal complications attributed to induced abortion

To estimate prevalence and factors of induced abortion both therapeutically induced and illegally induced and know clinical presentations and complications of induced abortion. Department of Gynaecology and Obstetrics Unit I. Bahawal Victoria Hospital. Bahawalpur affiliated with Quaid-i-Azain Medical College, Bahawalpur. This study was conducted from April 2001 to April. 2002. A prospective observational study. The sample size was 25 patients who fulfilled the criteria and were admitted to ward. A woman is labeled as case of illegally induced only on voluntary confession as per rule if is. A total number of 2150 women were admitted during the study period. Out of these 1775 [84.32%] had pregnancy related complaints and 315 [14.65%] had H/O abortion. Twenty five women [7.93%] had induced abortion i.e. 21 cases [6.66%] illegally and 4 cases [1.26%] therapeutic induced abortion. Induced abortion was common in illiterate [64%]. poor [44%], 25-34 years age group [68%]. Grand multiparae 52% having> 05 children. In 72% cases induced abortion was done during the first trimester and 80% of women had previous H/O abortion. Most cases of induced illegal abortion 84% were done by unskilled, semiskilled staff and instrumentation was the commonest method used. The most common symptoms were vaginal bleeding 40%, lower abdominal pain 68%, features of septicemia 64, fever 70% and common signs on admission were tachycardia [76%], abdominal tenderness 72% and vaginal examination showed OS open [64%] and adnexa tenderness [80%]. The complications countered were hemorrhage 36%, sepsis 28% and trauma to viscera 24% during the study period. Maternal mortality and morbidity attributed with induced abortion can be prevented/reduced by well integrated health care and family planning sources. Alleviation of illiteracy along with easy and free availability of reliable contraceptives and strict legislation to deal with person involved in inducing illegal abortion can improve the preventing situation

Histopathologic findings in dysfunctional uterine bleeding

To identify the hisopathologic patterns of endometrium in patients suffering from dysfunctional uterine bleeding [DUB] and its effects on female health. Descriptive Cross-sectional study. Department of Obstetrics and Gynaecology, Bahawal Victoria Hospital Bahawalpur from June 2003 to June 2004. One hundred married women of 15-45 years of age diagnosed as having DUB on history and clinical examination [including per-vaginal and per-speculum] under went D and C under anaesthesia and endometrial specimen obtained. Endometrial specimen fixed and preserved in 10% formalin and sent to lab for histopathological examination. Among 100 married women from 15-45 years of age, 80% were multiparous and commonest presenting symptoms were menorrhagia [35%] and polmenorrhagia [31%]. Histopathologic evaluation showed normal secretary phase of menstrual cycle in 28%, hormonal imbalance in 21%, endometrial hyperplasia in 44%, endometrial polyp in 4%, pill endometrium in 2% and endometrial carcinoma in 1% of cases. Anemia was present among 92% patients. Endometrial hyperplasia is the commonest pathologic alteration in patients with DUB and serious pathology [endometrial carcinoma] would have been missed if endometrial curettage was not done. It has profound effects on female health in the form of anemia